Verify Metronidazole

Drug JSON

This is exactly what your browser canonicalizes + SHA-256-hashes

{
  "slug": "metronidazole",
  "nameEn": "Metronidazole",
  "nameTh": "เมโทรนิดาโซล",
  "class": "Antibiotic / antiprotozoal — nitroimidazole",
  "mechanism": "ยากลุ่ม nitroimidazole ถูกรีดิวซ์ในแบคทีเรียที่ไม่ใช้ออกซิเจน (anaerobe) และโปรโตซัว เกิด radical ที่ทำลาย DNA ของจุลชีพ; ครอบคลุม anaerobe และโปรโตซัว (Giardia)",
  "brandNamesTh": [
    "Flagyl"
  ],
  "indications": [
    {
      "text": "การติดเชื้อ anaerobe, giardiasis, และภาวะลำไส้อักเสบบางชนิด รวมถึงใช้ใน hepatic encephalopathy",
      "cites": [
        "merck-nitroimidazoles-use-in-animals"
      ]
    }
  ],
  "contraindications": [
    {
      "text": "ระวังในสัตว์ที่มีโรคตับ (ลดขนาดยา); หลีกเลี่ยงในสัตว์ตั้งท้องระยะแรก",
      "cites": [
        "merck-nitroimidazoles-use-in-animals"
      ]
    }
  ],
  "sideEffects": [
    {
      "text": "⚠️ ความเป็นพิษต่อระบบประสาท (neurotoxicity): สั่น กล้ามเนื้อกระตุก เดินเซ (ataxia) จนถึงชัก — ขนาดยารวมต่อวันไม่ควรเกิน 65 mg/kg และมีหลักฐานพบพิษที่ขนาดต่ำกว่านั้น จึงควรระวังเมื่อให้ > 40 mg/kg ทุก 24 ชั่วโมง",
      "cites": [
        "merck-nitroimidazoles-use-in-animals"
      ]
    }
  ],
  "dosages": [
    {
      "species": "canine",
      "indication": "Giardiasis",
      "route": "PO",
      "dose": "25 mg/kg ทุก 12 ชั่วโมง นาน 5 วัน",
      "cites": [
        "merck-nitroimidazoles-use-in-animals"
      ]
    },
    {
      "species": "canine",
      "indication": "Inflammatory GI / IBD",
      "route": "PO",
      "dose": "10–15 mg/kg ทุก 12 ชั่วโมง",
      "notes": "ขนาดรวมต่อวันไม่เกิน 65 mg/kg (neurotoxicity); ระวังเมื่อ > 40 mg/kg/วัน",
      "cites": [
        "merck-nitroimidazoles-use-in-animals"
      ]
    }
  ],
  "citations": [
    {
      "id": "merck-nitroimidazoles-use-in-animals",
      "type": "textbook",
      "title": "Nitroimidazoles — MSD/Merck Veterinary Manual (Pharmacology)",
      "year": 2025,
      "url": "https://www.merckvetmanual.com/pharmacology/antibacterial-agents/nitroimidazoles-use-in-animals",
      "note": "Authoritative veterinary pharmacology reference — verified dose, spectrum, adverse-effect profile. Copyrighted, cited not mirrored.",
      "cid": null
    },
    {
      "id": "wikipedia-Metronidazole",
      "type": "monograph",
      "title": "Metronidazole — Wikipedia",
      "year": 2026,
      "url": "https://en.wikipedia.org/wiki/Metronidazole",
      "note": "Tertiary cross-check for class, mechanism, brand names. CC BY-SA 4.0. Not sole authority for any clinical claim.",
      "cid": null
    },
    {
      "id": "dailymed-metronidazole",
      "type": "regulatory-database",
      "title": "Metronidazole — NLM DailyMed (FDA Structured Product Labeling)",
      "year": 2025,
      "url": "https://dailymed.nlm.nih.gov/dailymed/search.cfm?query=metronidazole",
      "note": "Cross-checked source: FDA-approved labeling. Search by name returns relevant product labelings.",
      "cid": "a3ab5a5d404f9b950aae5658201af7e23845a77f83073faf88a09f9c959dd598"
    },
    {
      "id": "atc-P01AB01",
      "type": "guideline",
      "title": "ATC P01AB01 — Metronidazole",
      "year": 2025,
      "url": "https://www.whocc.no/atc_ddd_index/?code=P01AB01&showdescription=no",
      "note": "Cross-checked source: WHO Collaborating Centre ATC/DDD index. Authoritative drug classification.",
      "cid": "17d54b1b9629e50a03ea8f31a5e33025b4c6e201931fc94eef051e4d8a28d1fe"
    },
    {
      "id": "pubchem-metronidazole",
      "type": "monograph",
      "title": "Metronidazole — PubChem search",
      "year": 2025,
      "url": "https://pubchem.ncbi.nlm.nih.gov/#query=Metronidazole",
      "note": "Cross-checked source: chemical structure, identifiers, pharmacology summary. Faculty review fills exact CID.",
      "cid": "c75573a34557001f33fa64bf56f7ddbac95c42604a6b01d814f78a45b16bc736"
    },
    {
      "id": "who-eml-22",
      "type": "guideline",
      "title": "WHO Model List of Essential Medicines (22nd List, 2021)",
      "year": 2021,
      "url": "https://www.who.int/publications/i/item/WHO-MHP-HPS-EML-2021.02",
      "note": "Cross-checked source: drug appears on WHO EML — WHO recognizes its place in basic healthcare.",
      "cid": "71030c795c4e0c0cff56566bfc9ae4ed448eab9188ae68ce773a50d9f7fc53eb"
    },
    {
      "id": "wsava-amr-2023",
      "type": "guideline",
      "title": "WSAVA Therapeutic Guidelines Group — Library on Responsible Antimicrobial Use and AMR Prevention (2023)",
      "year": 2023,
      "url": "https://wsava.org/wp-content/uploads/2023/05/WSAVA-TGG-library-on-responsible-antimicrobial-use-and-AMR-prevention-2.pdf",
      "note": "Cross-checked source: WSAVA TGG framework for prudent antibiotic use in companion animals (PDF, stable URL).",
      "cid": "29f7ea6edf16004626349e036f3eb2ea30803ca1f6efd437bff0e8a4f2f465f1"
    }
  ],
  "mirroredFrom": [
    {
      "id": "dailymed",
      "name": "NLM DailyMed",
      "url": "https://dailymed.nlm.nih.gov/dailymed/search.cfm?query=metronidazole",
      "asOfDate": "2026-05-27",
      "license": "U.S. Government work — public domain. Attribution recommended."
    },
    {
      "id": "atc",
      "name": "WHO ATC Classification",
      "url": "https://www.whocc.no/atc_ddd_index/?code=P01AB01&showdescription=no",
      "asOfDate": "2026-05-27",
      "license": "WHO publication, free for use with attribution"
    },
    {
      "id": "pubchem",
      "name": "PubChem (NIH/NLM)",
      "url": "https://pubchem.ncbi.nlm.nih.gov/#query=Metronidazole",
      "asOfDate": "2026-05-27",
      "license": "NIH/NLM public domain"
    },
    {
      "id": "who-eml",
      "name": "WHO Model List of Essential Medicines (22nd List, 2021)",
      "url": "https://www.who.int/publications/i/item/WHO-MHP-HPS-EML-2021.02",
      "asOfDate": "2026-05-27",
      "license": "CC BY-NC-SA 3.0 IGO"
    },
    {
      "id": "wsava-amr",
      "name": "WSAVA TGG — Key Documents on Responsible Antimicrobial Use and AMR Prevention",
      "url": "https://wsava.org/wp-content/uploads/2023/05/WSAVA-TGG-library-on-responsible-antimicrobial-use-and-AMR-prevention-2.pdf",
      "asOfDate": "2026-05-27",
      "license": "Free for educational use with attribution"
    }
  ],
  "mirrorCIDs": [
    {
      "sourceId": "dailymed",
      "cid": "a3ab5a5d404f9b950aae5658201af7e23845a77f83073faf88a09f9c959dd598",
      "capturedAt": "2026-05-27",
      "status": "stub"
    },
    {
      "sourceId": "atc",
      "cid": "17d54b1b9629e50a03ea8f31a5e33025b4c6e201931fc94eef051e4d8a28d1fe",
      "capturedAt": "2026-05-27",
      "status": "stub"
    },
    {
      "sourceId": "pubchem",
      "cid": "c75573a34557001f33fa64bf56f7ddbac95c42604a6b01d814f78a45b16bc736",
      "capturedAt": "2026-05-27",
      "status": "stub"
    },
    {
      "sourceId": "who-eml",
      "cid": "71030c795c4e0c0cff56566bfc9ae4ed448eab9188ae68ce773a50d9f7fc53eb",
      "capturedAt": "2026-05-27",
      "status": "stub"
    },
    {
      "sourceId": "wsava-amr",
      "cid": "29f7ea6edf16004626349e036f3eb2ea30803ca1f6efd437bff0e8a4f2f465f1",
      "capturedAt": "2026-05-27",
      "status": "stub"
    }
  ],
  "codes": {
    "atc": {
      "code": "P01AB01",
      "name": "Metronidazole",
      "level": 5
    },
    "rxnorm": {
      "cui": "6922",
      "name": "Metronidazole"
    }
  },
  "drafting": {
    "aiAssisted": false,
    "aiModel": null,
    "aiPromptHash": null,
    "humanReviewer": "palmzamak2547",
    "humanReviewedAt": "2026-05-27",
    "humanEditsRatio": null
  },
  "signatures": [],
  "reviewedBy": null,
  "lastUpdated": "2026-05-27",
  "version": 1,
  "changelog": [
    {
      "version": 0,
      "date": "2026-05-27",
      "summary": "Seed entry — cross-checked from 5 authoritative sources (NLM DailyMed, WHO ATC Classification, PubChem (NIH/NLM), WHO Model List of Essential Medicines (22nd List, 2021), WSAVA TGG — Key Documents on Responsible Antimicrobial Use and AMR Prevention). ATC P01AB01 + RxNorm 6922. Thai translation + faculty review pending."
    },
    {
      "version": 1,
      "date": "2026-05-27",
      "summary": "Clinical content compiled from cited sources — metronidazole giardia 25 mg/kg q12h + IBD 10–15 mg/kg q12h + neurotoxicity ceiling 65 mg/kg/day (caution >40) verified against Merck Veterinary Manual (Nitroimidazoles). Every statement cited. Reviewed by palmzamak2547. Pending faculty canonical signature."
    }
  ],
  "interactions": [
    {
      "text": "อาจเพิ่มฤทธิ์ warfarin; ใช้ร่วม alcohol ทำให้เกิด disulfiram-like reaction",
      "cites": [
        "merck-nitroimidazoles-use-in-animals"
      ]
    }
  ],
  "monitoring": [
    {
      "text": "เฝ้าระวังอาการทางระบบประสาท (สั่น เดินเซ ตากระตุก nystagmus) โดยเฉพาะเมื่อใช้ขนาดสูงหรือนาน; หยุดยาทันทีหากพบ",
      "cites": [
        "merck-nitroimidazoles-use-in-animals"
      ]
    }
  ]
}

Public keys used

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